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May 2010--One in four people over the age of 70
suffers from gait disturbance. To prevent
falls, specific treatment should be given.
In the current issue ofDeutsches Ärzteblatt
Jahn and colleagues describe methods of
differential diagnosis and therapy (Dtsch
Arztebl Int 107: 306-16).
Gait disturbance is defined as unsteadiness
during walking that is worse than the normal
slowing of old age.
It often has multiple
causes; in elderly patients, fear is often a
precipitating or aggravating factor. A
vicious circle often arises in which fear of
falling leads to avoidance of movement, and
in turn to reduced fitness, lower confidence
in one's own balance, increased fear, and
increased danger of a fall. Depression and a
markedly impaired quality of life can
In order for the treatment to be as
effective as possible, the type of gait
disturbance and its causes must be precisely
analyzed. In their article, Jahn et al.
present effective diagnostic methods. For
example, the observation of parameters such
as step length, speed, body posture, and
variability while the patient walks a given
distance, once with eyes open and once with
eyes closed, enables classification of the
type of gait disturbance.